6

THE BIG STORY

SUNDAY VISION, April 5, 2015

GETTING TREATMENT for acid burns ABROAD

Buying acid is so easy, and

A litre of acid costs only
sh4,000. But to treat a minor
acid injury costs up to sh20m.
For many acid victims, that is
an automatic death sentence,
Carol Natukunda reports

uying acid is as easy as

reciting the alphabet.
I thought a vigilant
dealer would question
my motive and I would
maybe fumble without
an outright answer. To my surprise, I
got acid from the first store I went to.
There were no questions from the
attendant of this dilapidated garage
in Nakawa, a Kampala suburb. All
he wanted to know was getting the
specifics of the battery.
The battery is for a lorry, I told
him. You need three litres then.
Each costs sh4,000, he said.
There was no time for bargains. I
wanted to quickly get out of here.
Make sure you do not open it,
because it might be the end of you.
It is concentrated sulphuric acid. It
will ruin your skin, the mechanic
dressed in a dirty grey overall warned
me.
He packed for me three sealed
bottles of the corrosive liquid in
a black polythene bag. I paid him
and hurriedly excused myself. My
photographer was in tow, zooming
and taking pictures from a distance
in case of any eventualities.
Once I was completely out of the
vicinity, I pulled out the bottle and
held it in my hand to find out just
how easy it would be for pedestrians
to identify this dangerous liquid
and raise an alarm. Although the
label read Mixed Acid, it also
bore the warning CORROSIVE,
nobody noticed that I was dangling
dangerous stuff.
I effortlessly strolled through
the Nakawa Market with the
deadly liquid in my hand, as my
photographer clicked away.
Shoving and mingling with vendors,
wheelbarrow pushers, cyclists and
cleaners, it was business as usual.
The only few stares I got were
probably from those who did not
understand why the photographer
was taking my pictures.
I walked on with my acid to the
Uganda Manufacturers Association
(UMA) show grounds; and entered
the exhibition centre, where an expo
was going on. I moved on to the
zebra crossing at the Game Shopping
Mall, crossed and boarded a taxi
without anyone raising an alarm.
In some upmarket garages, petrol
stations and other outlets and in the
city, the attendants were all willing to
sell acid to me. Had I been up to no
good, I would have ended someones
life just like that!

DEATH SENTENCE
It seems like most of the acid victims
die in Uganda due to the huge costs
that come with treating the wounds.
For five months, Vision Groups
Dorothy Atim battled with the acid
injuries she sustained when her
boyfriend, Andrew Francis Obirai,
allegedly poured acid on her. Atim,
who was a sales representative
with Vision Group based in Soroti,
had been admitted to the Mulago
Hospital Intensive Care Unit. She
died in March 2014.
In February 2015, Josephine
Namanda, a resident of Namavunvu
village in Gayaza, was attacked with
acid on the Northern Bypass in
Kampala. After battling wounds for
two months at Mulago Hospital, she
passed away.
Earlier, in January 2015, 70-yearold Jennifer Kisiki and her son
Godfrey Mwesigwa, 40, succumbed
to severe wounds sustained from
an acid attack in Nabweru. They
were attacked on their way to their
Nansana home. The two were
showered with acid inside a car on
December 12, 2014.
Until her death on October 24,
2013, 25-year-old Melissa Nansubuga
had, for a month, watched her
nose fall off and her lips melt away
as a result of an acid attack she
suffered from a jealous husband.
She could not afford the initial cost
of medication about sh255,000
for three bottles of injection daily
which had to be administered for
seven days. Nansubuga eventually
died on October 24, 2013.

It may take
two months to
treat the mildest
acid injury and
as long as four
months or even
a lifetime to
treat the most
severe injuries.
DR. BEN KHINGI, Surgeon

The reporter managed to enter the UMA hall exhibition centre with the acid without being questioned
One in 10 victims die
Dr. Ben Khingi, a consultant surgeon
at the Mulago Hospital Plastic and
Burns Unit, says these injuries
and deaths are as traumatic to the
doctors as they are to the patients
and their caretakers. When you
know that it is intentionally caused, it
hurts even more, Khingi says.
The doctor sees the evil,
heartlessness and bitterness in
mankind. Acid injury disfigures,
blinds and cripples survivors and
the doctor can only restore some
limited normality. Some die, and the
doctor can do very little if anything
to prevent death in severe cases of
injury, he says.
Khingi explains that a survivor
of an acid injury may undergo a
minimum of two surgical operations,
in the mildest form of injury, and
as many as 20 operations in severe
cases.
It may take two months to treat
the mildest acid injury and as long
as four months or even a lifetime to
treat the most severe injuries, Khingi
says.
He explains that the healing occurs
in stages.
Initially, the burn wounds need to
close up. Then the deformities need
to be corrected, most times in stages.
The scars need constant care and
repeated surgical attention.
Treatment costs depend on the
type of injury and the extent or parts
of the body involved, Khingi stresses.
Treatment in the public hospitals

The undercover reporter moved with the corrosive in Nakawa Market

is resource limited. In the private
plastic surgery setups, it is expensive
and, therefore, limited to only a few
of the patients.
Khingi estimates that treatment
costs may range from sh20m to
hundreds of thousands of dollars

when treated abroad.

Surgery is expensive and
specialised. It is, therefore, not readily
accessible to most patients, he says.
One out of every 10 acid victims
die due to the severity of an acid
injury, according to Khingi. Most

THE BIG STORY

SUNDAY VISION, April 5, 2015

ranges from sh20m to hundreds of dollars

so is moving around with it

The cost of treating

burns: A survivors story

F
The reporter negotiating with mechanics for the acid

She leaves with the acid in a polythene bag

patients live with deformities because
they cannot be surgically corrected.
What must not be forgotten is
the psychological injury that the
patient lives through, which requires
counselling and support for a long
time, Khingi explains.
He believes that the sulphuric acid
commonly used in car batteries is
used to wreak havoc.
Doctors estimate that it takes
five seconds of contact to cause
superficial burns and 30 seconds to
result in full-thickness burns.
At the burns unit
When Sunday Vision visited the
burns unit at Ward 2C (Holland
Ward) on March 24, it was full to
capacity. We noticed both adults and
children were sharing a ward. One
man had bandages covering him
from head to the waist. Another had
his entire head bandaged and was
groaning in pain.
Enock Kusasira, the Mulago
Hospital public relations officer, is
hesitant to state whether the hospital
has enough capacity to handle acid

victims. That is a political issue, he

says.
However, a senior doctor at
the burns unit says they are
overwhelmed. Every month, we
receive two to four cases, and about
12 follow up visits in the outpatient
clinic. This is double the number
it was about 10 years ago, says a
source, adding: Remember, there
are other types of burns we receive.
Some from house fires, others,
especially children, who have been
burnt at home by accident.
In an earlier interview with Sunday
Vision, the in-charge of the burns
unit, Irene Ekel, said the attacks seem
to be seasonal.
During the festive season, the
number of victims is expected to
rise, Ekel said.
According to a 2011 acid situational
analysis report by the Acid Survivors
Foundation Uganda (ASFU), Uganda
had about 382 victims as of 2011,
58% of whom were in the central
region.
Continued on Page 8

or some survivors, it is a miracle when they

make it. Moses Ahimbisibwe was admitted for
eight months at Mulago Hospital, following
an acid attack from his business rival in 2011.
When I was admitted, there were over 20 people
receiving treatment. About five people had died by
the time I was discharged. It is like a miracle to be
alive. It is like you keep burning and getting rotten
inside every minute, Ahimbisibwe narrates.
At the time of admission, the extent of his burns
were about 47% never mind that he had been
rushed to hospital as soon as
his family could.
That is how deep the burns
had gone. They splashed all the
water you can think of in this
world, but the burning could
not stop. I cannot describe the
pain, he says.
The doctor (one Dr.
Sentongo) told me: If you want
full attention, get a private
room, so that we fight this
together. I knew I was going
to pay dearly, but this was a
matter of life and death; I had
no choice.
When Ahimbisibwe was
showered with acid, his shirt
was instantly torn into pieces.
Today, his glaring scars tell it all. Ahimbisibwes nose
is somewhat glued to his moustache. He breathes
through his mouth.
It is difficult to breathe through my nose. I
need surgery to rectify that. Some people do not
understand why my mouth is always open. I also
pretend to be picking my nose so that I do not look
awkward, Ahimbisibwe says, removing his sun
glasses to reveal the extent of
the damage on his facial
features.
He lost his left eye.
I think there was
too much liquid
decomposing
and piling
up, the eye
just burst
and popped
out of the
socket when
I was on my
hospital bed,
Ahimbisibwe
says. If I lost
this eye too,
I would be
a blind man!
he says, with a

dry laugh. Ahimbisibwe has sold everything he had

in order to foot his medical bills. Before the acid
attack in 2011, Ahimbisibwe was a promising young
entrepreneur. At just 35, he had a transport business,
a plot of land and a dairy farm at his country home
in Fort Portal. He was planning to build a home
for his wife and three children. Today, he is back to
scratch.
This (acid burns) is worse than any disease,
Ahimbisibwe says, removing his eye glasses.
He cannot estimate how much he has spent on his
treatment. Through fundraising by
friends, and his old mother who also
had to sell the little she had, it could
be over sh100m. And this was only
in a space of eight months.
I had to convince the doctor to
discharge me because the bills were
accumulating every day. I was the
breadwinner and my wife was with
me in hospital. I needed to go back
to work, even if I was in a sorry
state.
I had about four surgeries at
Mulago Hospital. Now I am left with
two more surgeries, which might
have to be done abroad at a cost
of sh50m. With acid, you cannot
be sure that you are safe until the
surgery has been done to remove
the dangerous bits.
Sometimes, the scars are itchy. I wear tight shirts
so that I do not have to scratch myself all the time,
he says.
Ahimbisibwe cannot describe how much pain he
has gone through. There are times you just groan
endlessly. The operations are mainly skin grafting.
In his estimation, Mulago Hospital has the best
qualified doctors, but they do not have the tools to
enable them to do their job well.
The machines there sometimes jam. Sometimes
you even have to buy the required drugs, which
you sometimes cannot afford. The bandage is free
of charge, but sometimes it would run out, he
narrates.
There were times I needed over sh600,000
per month for drugs such as strong pain killers
and creams to apply on the badly damaged
skin, which was very painful. Not to mention
the special pressure garments I had to buy
every single day at sh150,000 each.
These helped in preventing the
scars from swelling. Having only
one will lead to infections and
odour, he narrates.
Above all, he also had to hire a
private room at the Mulago Hospital
at a cost of sh30,000 daily.
Some of my friends were helpful.
They fundraised for me, but I had to sell
everything. My family (wife and three
children) still stay in a rented house. If
this had not happened, I would
have finished building by
now.Besides the medical
bills, Ahimbisibwe is
also still seeking
justice, as the
suspects were
released on
bail.

I am left
with two more
surgeries, which
might have to
be done abroad
at a cost of
sh50m.

Ahimbisibwe is yet to undergo more surgery

SUNDAY VISION, April 5, 2015

THE BIG STORY

Central region leads in acid attacks

From page 7

he most frequently
cited reason for
acid attacks was
conflict within
a relationship,
followed by
conflicts linked to business
or property matters. Nearly
a third had an unknown
cause. This is because there
was little or no evidence
about the attacks, reflecting
that these crimes were often
committed in isolated places
without witnesses, but also
reflecting poor record-keeping
by the Police and medical
authorities.
Of the 382 cases recorded
in Uganda, 16% of the victims
died and over half had severe
injuries. The study found that
on average, patients suffered
burns on their face (87%
of victims), head and neck
(67%), upper limbs (60%)
and chest (54%). Around a
third of victims (31%) suffered
complete or partial blindness.
The nature of the injuries
reflected the intended purpose
of acid attacks: to maim and
scar the victim for life, often
targeting the face.
WHAT IS POLICE DOING?
When contacted, the deputy
Police spokesperson, Polly
Namaye, could not give
estimates on how many
cases they receive in a given
period, saying they were yet to
compile the statistics on acid
attacks. However, sources said
the attacks were becoming
more common.
The Police boss, Kale
Kayihura, has consistently
called for a law on
importation, distribution and
sale of acid. Kayihura feels
that stringent measures should
be applied on acid sale, just
like firearms. The regulations,
he says, should also guide on
its importation. There is need
to record those who import
and store acid. We also have to
monitor how those people use
it without causing any harm to
others, the Police chief said.

Kayihura added that it is

difficult for the Police to stop
acid attacks, given that most
of them take place in domestic
settings. He says once there
is a law, it would be easy to
monitor chemical shops and
garages and other users of
acid.
Section 216 (g) of the
Penal Code Act provides
that perpetrators of acid
or burn violence intending
to maim are liable to life
imprisonment. Should an
acid attack committed with
malice aforethought lead to
death, then it is considered
murder (section 188) and is
punishable by death (section
189). The lesser crime of
attempted murder, covered by
section 204, provides for up to
life imprisonment.
WHAT CAN BE DONE?
Dr. Khingi says instant first aid
for any acid victim is to wash
off the acid with plenty of
water for 20 minutes or more,
remove clothes soaked in the
acid immediately to reduce
contact with skin. Then refer
the person for competent
medical attention.
In the past, acid was
advocated against by survivors
supported by Acid Survivors
Foundation Uganda (ASFU).
The organisation looked at
the legislative and legal issues,
the control of access to acid
to the public, the medical and
the social issues and advocacy
against acid violence.
Khingi appeals to the
Government to act and
regulate the acid industry.
The Government must

Kayihura has called for a

law on the sell of acid

FIRST AID FOR AN ACID VICTIM

Immediately rinse with a large amount of cool water to

reduce the risk of complications.

Flush the area for at least 20 minutes. Do not use a hard

spray of water, because it can damage

the burnt area.
As you flush the area, take off any clothing or jewellery
that has the chemical on it. Put on gloves to
protect yourself from the chemical, if you need
to remove it. Have the person with the burn remove the
chemical substance if he or she is able.
If the area still has a burning sensation after 20 minutes,
flush the area again with flowing water for 10 to 15
minutes. Sulphuric acid is flushed with a mild,
soapy solution if the burns are not severe. Sulphuric
acid feels hot when water is added to it, but
it is better to flush the area and not leave
the acid on the skin.
While flushing the eyes, use lukewarm water
and keep the eyelids open at all times to allow
uninterrupted flushing to rinse every last
residue of acid.
Rush to the hospital as soon as you can.

realise that acid violence is a

vice it must stop by setting up
controls that other countries
have in place.
Acid used in an attack is a
lethal weapon and an attack
is an attempt on a life. The
public can and should not
accept this vice that can be
turned against anyone for any

reason, Khingi says.

Sunday Vision has
established that car batteries
commonly use acid diluted
to 20% 25%. If this acid
was only available at this
dilution point rather than
in its concentrated form,
some doctors estimate that
consequences of any attack

would be far less devastating.

Bangladesh provides a
striking example of what
can be achieved through
appropriate legislation. In
2002, parliament enacted two
laws against acid violence:
Under the Acid Control
Act of 2002, the unlicensed
production and importation

can get the same prison term.

Fines and custodial
sentences are imposed on
perpetrators, and the money is
used to compensate victims or
their families. Since then, acid
violence has been on a rapid
decline. There were 192 acid
cases in 2001, compared to
about 400 cases in 2001.